Why Haven't Infertile Couples Been Told These Facts?

February 23, 2010
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Millions of people have celiac disease, but most don’t know they have it, in part because symptoms can be so varied. It is an often overlooked digestive disorder that causes damage to the small intestine when gluten, a protein found in wheat, barley and rye, is eaten.

Infertility seems to be more common in women with untreated celiac disease. Other gynecological and obstetrical problems may also be more common, including miscarriages and preterm births.

For men, problems can include abnormal sperm -- such as lower sperm numbers, altered shape, and reduced function. Men with untreated celiac disease may also have lower testosterone levels.

The good news is that with proper treatment with a gluten-free diet and correction of nutritional deficiencies, the prognosis for future pregnancies is much improved.

Celiac disease -- which prevents your body from properly digesting gluten, a protein found in wheat, rye, and barley – may be far more common than previously thought. A decade ago, it was believed that celiac disease affected just one in 10,000 Americans.

But a 2004 report by the National Institutes of Health (NIH) estimates that as many as one in every 133 Americans have it. That equates to roughly 2 million people suffering from gluten intolerance in the US alone.

Unfortunately, celiac disease can manifest in so many ways, it’s frequently misdiagnosed and/or mistreated. One study showed it takes an average of 11 years for patients to receive a correct diagnosis!

What is Celiac Disease?

Celiac disease (CD) is an autoimmune disease, much like lupus and rheumatoid arthritis. To get the disease, you must have both a genetic predisposition plus an environmental factor that triggers the disease.

If you have celiac disease, eating gluten triggers an autoimmune response, provoking your body to attack itself and destroy healthy tissues, especially the villi in your small intestine. This can also have a detrimental effect on your body’s ability to absorb and process nutrients.

Some of the most common symptoms of this disease process include:

Chronic diarrhea

Gas

Bloating

Acid reflux

Constipation

Even a small amount of gluten can trigger a response.

How Celiac Disease Can Affect Your Fertility

In the New York Times article above, Dr. Sheila Crowe, a professor in the division of gastroenterology and hepatology at the University of Virginia, provides information about a slightly lesser known side effect of celiac disease, namely infertility, which can affect both men and women with the disease.

Studies from various countries indicate that fertility problems are indeed more common in women with untreated celiac disease, compared to women who do not have it.

The risk of suffering other gynecological and obstetrical problems like miscarriage or preterm birth is also higher for those with celiac disease.

In addition, other common menstrual disorders that frequently affect women with celiac disease include:

Later onset of menstruation

Earlier menopause

Secondary amenorrhea (a condition in which menses starts but then stops)

These menstrual abnormalities, along with other hormonal disruptions they cause, can lead to fewer ovulations, which in turn results in a reduced chance of pregnancy.

Men with the disease, especially if it’s undiagnosed, can also face fertility problems due to:

As Dr. Crowe recommends, it might be wise to get screened for celiac disease if you suffer from repeated miscarriages or are unable to conceive for unknown reasons – especially if you suffer any of the most common symptoms.

Just remember that symptoms can vary widely, and symptoms are easily confused with those of other diseases, such as irritable bowel syndrome, iron-deficiency anemia, or even chronic fatigue syndrome.

Fortunately, there are now more reliable blood tests that can screen for the disease, so that you’re not left guessing and wondering.

People with celiac disease have higher than normal levels of certain autoantibodies in their blood. So to diagnose celiac disease, your doctor will need to test your blood for high levels of anti-tissue transglutaminase antibodies (tTGA) or anti-endomysium antibodies (EMA).

Please keep in mind that you need to continue eating a diet containing gluten, such as breads and pastas, in order to obtain an accurate test result! If you go on a gluten-free diet prior to being tested, the results may come up negative for celiac even though you might in fact have the disease.

If the test is positive for celiac disease, a biopsy of your small intestine may be performed to confirm your diagnosis. The biopsy checks for damage to the villi, which is a sign that celiac disease is damaging your intestines.

The Case for a Low- or No-Grain Diet – Whether You Have Celiac Disease or Not

The prevalence of celiac disease is yet more evidence that contemporary humans simply aren’t equipped to consume mass quantities of starch and sugar rich foods many modern diets consists of.

Most people simply consume far too much bread, cereal, pasta, corn (a grain, not a vegetable), rice, potatoes, snacks and junk foods, with grave consequences to their health.

Many of you are still focused on fat intake, but it’s really not the fat in the foods you eat but rather the excess carbohydrates from your processed food diet that is making you overweight and unhealthy, and contributing to epidemic levels of other diseases such as diabetes.

If you have celiac disease, it’s imperative that you do not eat gluten in order to avoid further damage to your health. But it’s not only people with gluten intolerance who would benefit from avoiding grains--in my estimation over 85 percent of the population would benefit from avoiding them, and this includes even whole, organic grains.

Remember, if you stick to a diet consisting mainly of whole foods, preferably locally-grown organics, you’ll reap all the other beneficial side effects as well, such as increased energy, an enhanced mood, and a lower risk of other chronic illnesses.

Once you realize how good you can feel on a gluten-free diet, you’ll probably have no problem avoiding it and living a full, healthy life!

Additional Resources

For more in-depth information about celiac disease and going on a gluten-free diet, here are three good sources: